Akahoshi K, Motomura Y, Kubokawa M, Matsui N, Oda M, Okamoto R, Endo S, Higuchi N, Kashiwabara Y, Oya M, Akahane H, Akiba H. Endoscopic submucosal dissection of a rectal carcinoid tumor using grasping type scissors forceps. World J Gastroenterol 2009; 15(17): 2162-2165 [PMID: 19418591 DOI: 10.3748/wjg.15.2162]
Corresponding Author of This Article
Kazuya Akahoshi, MD, PhD, Department of Gastroenterology, Aso Iizuka Hospital, 3-83 Yoshio, Iizuka 820-8505, Japan. kakahoshi2@aol.com
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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Kazuya Akahoshi, Yasuaki Motomura, Masaru Kubokawa, Noriaki Matsui, Manami Oda, Risa Okamoto, Shingo Endo, Naomi Higuchi, Yumi Kashiwabara, Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
Masafumi Oya, Department of Pathology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
Hidefumi Akahane, Haruo Akiba, Fujifilm Corporation, Saitama 331-9624, Japan
Author contributions: Akahoshi K and Motomura Y performed ESD; Akahoshi K, Akahane H and Akiba H developed a grasping type scissors forceps; Oya M performed histological analysis; Akahoshi K, Motomura Y, Kubokawa M, Matsui N, Oda M, Okamoto R, Endo S, Higuchi N and Kashiwabara Y wrote the paper.
Correspondence to: Kazuya Akahoshi, MD, PhD, Department of Gastroenterology, Aso Iizuka Hospital, 3-83 Yoshio, Iizuka 820-8505, Japan. kakahoshi2@aol.com
Telephone: +81-948-223800
Fax: +81-948-298747
Received: January 11, 2009 Revised: March 14, 2009 Accepted: March 21, 2009 Published online: May 7, 2009
Abstract
Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the inability to fix the knife to the target lesion, and compression of the lesion. These can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (GSF), which can grasp and incise the targeted tissue using electrosurgical current. Colonoscopy on a 55-year-old woman revealed a 10-mm rectal submucosal nodule. The histological diagnosis of the specimen obtained by biopsy was carcinoid tumor. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. It was safely and accurately resected without unexpected incision by ESD using a GSF. No delayed hemorrhage or perforation occurred. Histological examination confirmed the carcinoid tumor was completely excised with negative resection margin.